This post is intended for veterans with post-traumatic stress disorder (PTSD) who also experience suicidal ideation symptoms. PTSD is prevalent among military personnel who have served our country. Suicidal ideation, also referred to as SI, is a common side effect of PTSD.
The VA has developed vast resources for the prevention, care, and treatment of veterans at risk of suicide. Yet the VA has been known to fall short when rating service-connected PTSD disability claims where suicidal ideation is present.
Signs and symptoms of suicidal ideation are underrated or overlooked if the VA rater does not correctly consider SI in their decision. The reality is that either passive or active suicidal ideation warrants a minimum of 70% disability rating.
If a similar error has caused your PTSD claim to be underrated, there are ways to improve that rating.
You Have Options When the VA Misjudges Your Suicidal Ideation Symptoms
If you disagree with the VA’s decision regarding your suicidal thoughts, or if signs of SI have appeared after your initial disability rating was issued, the VA offers review options through which you can pursue a fair rating.
- Higher-Level Review: With this option, a more experienced VA rating specialist at the VA regional office gives a final decision on your claim
- Supplemental Claim: This option is helpful if you have identified missing records or have new evidence to back your case
- Appeal the Decision to the Board of Veterans’ Appeals (file Notice of Disagreement – NOD)
Our attorneys know the VA review and appeals system well.
- We can help you compile additional medical and vocational evidence of disability, identify initial decision errors, and address service connection issues.
- Our legal team knows how a well-written lay statement from family, friends, spouse, military colleagues, employers, and co-workers can strengthen your claim.
- Buddy statements written by fellow service members are potent components of a winning PTSD claim
- We will add clarity in describing symptoms of suicidal ideation and other PTSD side effects to present a compelling argument for the benefits you deserve.
We can help you in these ways and more.
For a free legal consultation, call 800-562-9830
What Is Suicidal Ideation?
Thoughts of committing suicide are referred to as suicidal ideation. There is no single, universally accepted definition of SI. It is an umbrella term covering thoughts, contemplations, or wishes of death, or actively engaging in suicide-related conduct.
The VA defines SI as “thoughts of engaging in suicide-related behavior,” with various degrees of frequency, intensity, and duration, as follows:
- Suicidal Ideation, Without Suicidal Intent
- Suicidal Ideation, With Undetermined Suicidal Intent
- Suicidal Ideation, With Suicidal Intent
What Are the Warning Signs of Suicidal Ideation?
It can be hard for someone with SI to express their thoughts and preoccupations with suicide. The person may talk about:
- Wanting to die
- Their guilt, failure, or shame
- Believing others would be better off if they were dead
- Being a burden
- How their pain and anguish is unbearable or overpowering
The person may feel:
- Empty, hopeless, trapped, or their life has no purpose
- Immensely sad, or anxious, or filled with rage
- Intolerable physical pain or emotional distress
- Like they wish they could go to sleep and not wake up
The person may show major shifts in their behavior:
- Planning how to end their life, exploring ways to do so
- Withdrawing from friends
- Behaving dangerously, like reckless driving and speeding
- Displaying extreme mood swings, which can lead to suicidal thoughts
- Excessive eating or sleeping
- Resorting to alcohol or drugs to escape
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Suicidal ideation appears first and only in the 70% evaluation criteria.
Suicidal ideation is one of the symptoms associated with a 70% VA disability rating. There is no mention of SI symptoms or side effects at lower VA rating levels.
Unfortunately, veterans’ claims declaring symptoms of suicidal ideation have often been rated too low or denied on the basis that a veteran’s “passive” SI did not rise to the level proposed by the 70% VA rating.
Underrating occurs when VA raters, depending on the facts of the case, wrongly determine that the veteran:
- is at low risk of self-harm,
- can still function socially and occupationally
- is getting sufficient treatment
It took a recent decision by the VA Court of Appeals for the VA to clarify its understanding of suicidal ideation under the guidelines concerning veterans’ disability compensation.
In the 2017 case Bankhead v. Shulkin, the higher court decided that a 70 percent disability rating should be assigned when suicidal ideation is present. The SI may be active or passive.
Below are the Court’s findings, as held Under 38 C.F.R. § 4.130,
“… the presence of suicidal ideation alone, that is, a veteran’s thoughts of his or her own death or thoughts of engaging in suicide-related behavior, may cause social and occupational impairment with deficiencies in most areas.
Additionally, there are no descriptors, modifiers, or indicators as to suicidal ideation in the 70% criteria (including no specific mention of “active” suicidal ideation, “passive” suicidal ideation, suicidal “intent,” suicidal “plan,” suicidal “preparatory behavior,” hospitalization, or past suicide attempts).
Thus, the language of the regulation indicates that the presence of suicidal ideation alone, that is, a veteran’s thoughts of his or her own death or thoughts of engaging in suicide-related behavior, may cause occupational and social impairment with deficiencies in most areas.”
In plain English, this means either passive or active suicidal ideation is, at a minimum, deserving of a 70% disability rating:
- You do not have to show “evidence of more than thoughts,”
- You do not need to have had inpatient treatment or hospitalizations,
- You do not need to have total social and occupational impairment.
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What Are the 70 and 100 Percent Ratings for PTSD?
Below are the full criteria for 70 and 100% VA ratings. When you look through all the listed symptoms, you can see that the level of disability has distinctly become more severe.
Criteria for a 70% Mental Health Disability Rating
“Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as:
- suicidal ideation
- obsessional rituals which interfere with routine activities
- speech intermittently illogical, obscure, or irrelevant
- near-continuous panic or depression affecting the ability to function independently, appropriately, and effectively
- impaired impulse control (such as unprovoked irritability with periods of violence)
- spatial disorientation
- neglect of personal appearance and hygiene
- difficulty in adapting to stressful circumstances (including work or a work-like setting)
- inability to establish and maintain effective relationships.”
The 70% PTSD rating is the threshold where the most severe symptoms of PTSD begin to appear, and the veteran’s ability to work and function in society is severely impacted. This level of disability rating means securing significantly higher disability benefits – and, just as important, ensuring the mental health care and treatment you need.
It is the image of someone who is having a very hard time functioning independently and appropriately. Occupational and social relationships aren’t just difficult; you cannot maintain them.
You don’t need to have every symptom to get the 70 percent PTSD rating. You could feasibly have only one or two of the specifically listed symptoms for PTSD documented in your medical records and still get a 70% VA PTSD rating. Likewise, the presence of suicidal ideation alone is no guarantee that you will get a 70% rating.
Criteria for a 100% Mental Health Disability Rating
“Total occupational and social impairment, due to such symptoms as:
- gross impairment in thought processes or communication;
- persistent delusions or hallucinations;
- grossly inappropriate behavior;
- persistent danger of hurting self or others;
- intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene);
- disorientation to time or place;
- memory loss for names of close relatives, occupation, or name.”
A 100% PTSD rating is when the veteran suffers total occupational and social impairment.
PTSD and all mental health VA ratings are under 38 CFR 4.130 − Schedule of Ratings-Mental Disorders.
Reluctance to Talk about Suicidal Ideation Can Cause Low VA Ratings
Screening for suicidal ideation and prior suicide attempts by the VA has become standard practice. Yet veterans may feel uncomfortable talking about or admitting to suicidal ideations during screening.
Stigma reinforced by our military culture often translates into a belief that you will be treated differently or seen as weak if you ask for help or admit thoughts of suicide. You’ve been trained to overcome pain, never show vulnerability, and defeat doubt. This aversion to seeking help can ultimately hinder your rightful access to and participation in critical PTSD treatment and suicide prevention programs.
Going after and getting maximum disability benefits should not be “more acceptable” only when your wounds are visible.
Our Accredited VA Attorneys Can Help.
We work with veterans with SI to overcome barriers that prevent them from getting their rightful benefits. Our attorneys are on your side and here to fully support you under the law.
We want you to know how beneficial it is to your case to be upfront and complete in talking about your suicidal ideation.
Being honest and inclusive with the VA examiners about your symptoms is essential. This can mean the difference in the VA awarding you a 30 or 50 percent VA rating versus a 70 percent or even 100 percent rating for PTSD.
Call on Marc Whitehead & Associates’ veterans legal team to serve as your legal advocates and support system through this process.
We also raise the issue of your entitlement to TDIU before the VA
In PTSD cases, a veteran’s unemployability may be sufficient to reasonably claim entitlement to a unique VA disability compensation program called Total Disability Based on Individual Unemployability (TDIU), which is also called Individual Unemployability (IU).
The unique TDIU rating pays 100% of total disability compensation to a veteran who can’t work yet whose service-connected disabilities are not rated as 100% disabling.
It will be your burden to demonstrate that your evidence of record reasonably raises entitlement to TDIU. This evidence must suggest that your service-connected PTSD renders you unemployable.
Our attorneys will help ensure the VA sees your limitations’ full scope and reality.
Don’t let the VA system’s complexities deter you from seeking the compensation and help you are entitled to.
Be selective in your choice of attorney. Choose a law firm based on the skills, compassion, and experience of the people within it.
At Marc Whitehead & Associates, our VA disability lawyers are recognized and trusted for their ability to handle the most complex veterans’ disability benefits matters. We welcome your call.
Call or text 800-562-9830 or complete a Free Case Evaluation form
